I have throughout the pandemic pressed for more drug trials to improve treatments. We are now seeing some good progress.

 

Question:
To ask the Secretary of State for Health and Social Care, if he will list the drugs the NHS can use to treat covid-19 patients. (91820)

Tabled on: 13 December 2021

Answer:
Maggie Throup:

The following therapeutics are available to patients hospitalised with COVID-19 and in the community setting:

– Dexamethasone;

– Tocilizumab;

– Ronapreve; and

– Sotrovimab.

The following antivirals are available to patients in both hospital and community settings:

– Remdesivir;

– Molnupiravir; and

– PF-07321332

The answer was submitted on 23 Dec 2021 at 10:47.

John Redwood: We cannot continue being governed by scientific advisers

 

 

         I am writing to wish you a happy Christmas and to look forward to a better new year. I have been keen to support those in government determined to avoid any ban on family get togethers and visits to local restaurants and cafes over Christmas in contrast to 2020.  It looks as if we will enjoy some  of our traditional freedoms.

 

      I have not taken this view without considering very carefully the evidence of how we can best control the pandemic. Reliance on vaccines is our first line of defence and they seem to be working well. The gradual introduction of better drug treatments also helps cut serious case rates. I have been urging completion of more drug trials and more work on better air extraction and UV cleaning of circulating air to cut the risk of the virus in indoor public spaces.The government promise me they are pressing ahead with this. The early evidence on Omicron suggests this is for most  a milder version with less infection of the lungs which has been the danger in other variants. 

 

       We are going to have to live with strains of this virus for some years to come, just as we do with flu which can also be a nasty killer for some. The U.K. government did well to back and support one of the first successful vaccines and then to roll out a large and early vaccination programme to greatly reduce the risks of death for many people. Armed with  other improvements we should  now let people make more of their own judgements about how to cut the  risks of the disease themselves.

 

         I am pressing the government to get on with measures to promote more prosperity, more and better paid jobs, and more U.K. self reliance in everything from energy to food. I am proposing how to cut supply shortages which lead to inflation and how to reduce the  cost of living squeeze which will be bad in April without further changes of approach. 

 

          There is some disquiet about the apparent breaching of covid rules by senior officials in government. The PM is right to commission a proper enquiry and will then need to take disciplinary action if offences occurred. 

 

         

I am all in favour of experts. I read a lot of expert opinion. Daily I learn something new from reading someone’s research findings about issues of public interest.

Reading plenty of experts has taught me several things. It has taught me that some so called experts are not up to the title, producing ill thought through material with insufficient proof.  The BBC is specially good at mistaking establishment propagandists for experts. It has reminded me that in many difficult areas the experts disagree amongst themselves, which is often a welcome  way of moving towards a greater understanding of the issue. I have also discovered in fields I study that there can often develop an expert consensus, held by many for fear of getting out of line. This can result in a catastrophic establishment failure because most of the tenured individuals dare not disagree. In economics the Exchange Rate Mechanism  boom and bust  and the banking crash great recession are two  examples of groupthink gone wrong.

The worst feature of recent years has been when the establishment consensus allies itself with political forces and tries to dominate the democratic debate about a topic. The Treasury and Bank of England forecasts prior to the referendum we now know were wildly wrong and were clearly designed to help the Remain campaign. They forecast a fall in house prices, a fall in employment, a rise in interest rates and a fall in the pound if we left. Instead in the early months after we finally left the reverse of all those forecasts occurred. In the year immediately after the vote as well house prices rose, employment went up and interest rates went down. This poor forecasting undermines public confidence in official forecasts. It also angers the majority who disagreed with the establishment political view on the underlying question.

Today expert epidemiologists need to grasp that their forecasts will be carefully scrutinised  and subjected to commonsense checks because of past forecasting errors by government advisers. Net zero advisers keen to speed the transition will need to ask why the public does not rush to transform their lives in the recommended ways. They will find they need to overcome scepticism about some of their claims.

Democracy places non experts in positions of power to take advice, to consider conflicting expert claims and to apply some commonsense to recommendations. It remains the best way of proceeding in a world where the future is always uncertain. For a democracy to thrive we need to debate the cosy and sometimes horribly wrong consensus views of a self selecting group of experts in any given area. No one peddling views gets a ride free from criticism in a thriving democracy.

We soon will need to put the worst of the pandemic measures behind us and concentrate on the promotion of prosperity for the many. Controlling the disease should rest on the offer of vaccinations, better treatments, individual decisions about reducing the risk of infection and better air extraction and cleaning in public buildings.

The Treasury needs to acknowledge that its policy is going to squeeze the economy too much in the first half of next year. If they persist with their raft of tax rises in April, hitting just when energy prices rocket with the shifting of the price caps, we will see an unwelcome relapse in confidence, incomes and output.

The Treasury should announce now that it will not impose the hike in national Insurance, a tax on jobs and on take home pay, at the peak of the cost of living troubles. It should remove VAT on domestic fuel to ease the large rise in energy costs for consumers.

The Treasury should work with the Business department to increase the supply of domestic energy. Gas is a so called transition fuel which will be much needed this decade before new nuclear and other reliable carbon free electricity comes on stream. Gas also remains the dominant way of heating homes, as people are not yet ready to adopt electric and heat pumps based home heating. The government should give the go ahead of additional UK gas production, starting with the Jackdaw field and other projects ready to go. The government should also commission more gas storage capacity to help smooth wild fluctuations in  spot market prices of gas.

The government should procure more reliable electricity supply from domestic sources as we are too dependent on imports when there is little wind.The Treasury should work with the Environment Department to fashion support schemes to promote more food production at home instead of offering money to prevent farming here, supporting imports.

All the time government advisers tell us to avoid social contact the Treasury needs to offer help to social contact service businesses.It needs at least to continue  business rates relief and lower VAT, and should offer direct assistance for cash flow problems of otherwise solvent businesses.

Question:
To ask the Secretary of State for Health and Social Care, what recent estimate he has made of the number of hospital beds that will be needed for cases of the Omicron variant of covid-19 in January based on the latest forecasts. (91819)

Tabled on: 13 December 2021

Answer:
Maggie Throup:

In the absence of any data on disease severity or the likely transmission rates in the community, it is not possible to make any reliable estimates of predicted future hospitalisation rates or the number of hospital beds required for cases of the Omicron COVID-19 variant. As data on transmission rates becomes clearer over time and the initial hospitalisations allow assessment of severity and care needs, the UK Health Security Agency (UKHSA) will be able to generate projections of predicted future hospitalisation rates. The UKHSA and NHS England and NHS Improvement are working together to collate this data as quickly as possible.

Yesterday the Secretary of State for Health took to the pages of the Daily Telegraph to explain why he wants a more cautious policy. The crucial passages said

“We face a tsunami of infections in the coming days and weeks. Omicron spreads at a pace we have never seen before and has been doubling about every two or three days. Yesterday saw more than 90,000 new cases reported across the UK…..The ultimate risk is that hospitalizations overwhelm the NHS”

 

Of course an easily transmitted disease will show very fast growth on first arrival on a small base. You would also expect the percentage rate of increase to slow as the number of people infected by it rises. It cannot go on doubling or growing at all were every one to get it, and well before it reaches that level you would expect a slower growth rate before subsiding again. It doesn’t take many days to cover the whole population if it did go on doubling in less than two days.

 

But note the confusion in this statement between total covid cases including all variants, and numbers of Omicron cases. In recent days there has  not been anything like a doubling of covid cases as a whole. Some of the fast growth in Omicron has been offset by declines in other versions of the disease. The last four days produced 87,565 (16 Dec), 92,503 (17 Dec) and 89, 074  (18 Dec) and 82,886 (19 Dec).

We now know that the modellers have not been modelling better outcomes, distorting the task for decision takers of weighing risks and probabilities of bad outturns.  When the scientists rightly warn that they cannot yet know how fast this will spread or how serious an illness it may give people until they have more data it is very important to provide good as well as bad scenarios to inform a sensible discussion about how much risk to run.

Hospitalizations were running at a recent peak of 9.345 on the seven day average on  6 November. This had fallen to 7549 by 16 December. This compares with an all time covid peak of 38.389 in Jan 2021.

Many people are fed up with alarmist scientific forecasts which turn out to greatly exaggerate the numbers who will suffer a serious illness. The data used needs to be accurate, relevant and presented fairly.

 

I have delayed the economic piece until tomorrow as this CV 19 issue  is even more topical.

The idea of democratic politics is to elect Ministers who can draw on the best possible expert advice, but then apply commonsense and judgement to it to fashion acceptable policy. Always Ministers have to balance advice on topic A against advice on topics B and C because government is rarely allowed one single simple objective. In the world of the pandemic Ministers need policies that control deaths from non covid as well as from covid, and allow the country to produce food and energy so we do not freeze or starve. They need to balance a range of needs and aims. They also often have to adjudicate between conflicting expert advice. They should not just take the official advice from government advisers if there is a danger it is wrong.

We see these tensions at play with the official advisers on covid understandably wishing to lock everything down as much as possible  as their sole aim is to eliminate the disease and only by stopping all contacts between people could you guarantee to do so this. I also note these experts  honestly tell us they do  not yet know how far and fast Omicron will spread nor how serious an illness it might induce. That does not stop them putting out estimates of a surge in cases and possibly in serious cases too to try to bias the decisions of a government trying to find an appropriate balanced response.

I see the dangers of relying on expert opinion more obviously in the world of economic policy, where the OBR/Treasury  and Bank of England have been spectacularly wrong about many things in recent years. It is easier for me to criticise as I did offer alternative forecasts and policy advice at the time. They disastrously forced through membership of the European Exchange rate Mechanism causing a savage boom/bust. They failed to control excess credit in the banking bubble of 2005-7 and then decided to bring the banking system to collapse by over correction in a hurry. After rightly offering substantial stimulus and low interest rates to offset some of the damage of the first general pandemic lockdown, they more recently have misread the inflationary pressures and then decided to sandbag the economy just when the next wave of the virus is slowing things down anyway.

The Chancellor needs to break free from the tyranny of the OBR debt and deficit austerity economics, and set about promoting growth and removing supply bottlenecks by helping boost capacities at home. I will tomorrow set out a package of measures he could announce that would start to tackle the looming cost of living crisis and the slowdown induced by too many tax rises to come.

The Department of Health and Social Care has provided the following answer to your written parliamentary question (90313):

Question:
To ask the Secretary of State for Health and Social Care, what plans he has to increase the number of beds in NHS England hospitals. (90313)

Tabled on: 09 December 2021

Answer:
Edward Argar:

National Health Service bed capacity is not fixed and can be flexible to meet changes in demand.

The seasonal flu and COVID-19 booster vaccination programmes also aim to reduce the level of hospital admissions and increase bed capacity. We have also provided an additional £478 million to the NHS for the rest of this year to continue the enhanced hospital discharge programme, to maximise the number of available beds.

The answer was submitted on 15 Dec 2021 at 16:16.

Let me begin by repeating my gratitude to all those NHS staff who worked beyond the call of duty and took risks themselves to look after all too many covid patients. My criticisms of senior management below do not take anything away from their covid work done.

The issue I have been raising for a long time is why does the NHS run down the number of beds or fail to increase them? This government has made available very large extra amounts of money both to improve the mainstream NHS and to respond to the special challenge of covid 19. As we found during past periods of accelerated funding increases as well  there has been a marked reluctance to ever use this to expand bed capacity. Staff numbers have expanded, but maybe not enough of the specialists  needed for  crucial clinical and nursing teams to staff additional beds. There has been plenty of expansion of the overhead, with more regulatory and policy quangos.

When the NHS was persuaded to spend substantial sums on setting up and equipping the Nightingales they obtained around 5000 extra beds with space to expand that further. I urged them to make these the covid hospitals, isolating patients who would otherwise go to the District Generals who could get on with their regular work.  Of course the NHS had to re purpose medical staff so more worked on covid all the time it was raging and had to recruit as many extra as possible for temporary or more permanent work. Instead the NHS insisted on putting covid patients mainly into the District General hospitals. This created cross infection problems and reduced the capacity of the NHS to carry on with non covid work. The NHS then shut the Nightingales as soon as possible for a total cost of around £500 m. As you can see from a  recent Parliamentary answer I received we are not allowed to know where all those beds and equipment have gone to. Surely they should be put to good use?

The non answer to the two questions above shows a strong reluctance to even countenance expanding the number of beds. Why? When money is available it is a good time to do so.